Thursday, December 15, 2011

Change of Plans

I had planned on taking it a little easier this race season and do fewer races. I raced almost every weekend last winter and extended my season longer than usual with World Masters in March, and I felt like I needed a break. I did not anticipate how much of a break I'll likely need, however. In early November I was diagnosed with breast cancer, which pretty much changes everything. Needless to say, my training focus changed completely from racing to simply staying strong and healthy to help me get through treatment. I continued to train, but took things much easier. If I felt a bit tired, I backed off. There seemed no sense in tiring myself out needlessly. The original biopsy showed that I had caught it very early. The tumor was small, about 8mm, not aggressive, and a common more easily treatable variety which meant it was unlikely I'd need chemo. So that was all reassuring, but I had to wait 3.5 weeks for surgery when we would truly know the extent of disease and confirm the course of treatment. The waiting was brutal.

I found out the morning of our weekly team practice. I knew I had to go since exercise is my best stress reliever. I was very teary when I told my teammates, but they were incredibly supportive. (One of the many benefits of team membership. :-) I only told them, my husband, my mother, and my boss at work. I didn't tell my extended family, children, or other friends because I wanted to maintain a sense of normalcy and not have everyone on pins and needles around me. My teammates were great. I could talk about it to them, but it was never dwelled on and I was able to enjoy practice and talk about other important things like life and skiing.

I was a wreck the days before surgery. The morning of I was pretty calm. In many ways it was like ski racing. I get terribly nervous right before the race but that all goes away the second the gun goes off. Same with surgery. Plus you feel like you have to pee constantly even though you just went and you get a plastic bag with your name on it to put your clothes in. The day was very long because of a surgery backup at the hospital and the various procedures I had to do before surgery. The surgery was a lumpectomy and included what is called a sentinel node biopsy. Cancer in lymph nodes is a good indicator that it may have spread and so requires more treatment. To find that out, they remove a couple nodes and look at them. You have lots of nodes in your armpit and they try to figure out which nodes cancer would travel to first and only check those instead of taking them all. To do that they inject you with a radioactive fluid and then get an x-ray to see which nodes suck it up first. They also inject you with a blue dye and see where that goes. The nodes it goes to first are the ones any cancer cells floating around would also go to. So if those are clear, you're clear. All that took several hours getting wheeled around to various departments for the various things. The worst part was that I couldn't eat and my stomach was so empty I almost felt nauseous. It's hard for someone who eats like a hobbit (as my husband likes to say) to go that long without food. Then it was time to get the IV and prep for surgery. I spoke to the anesthesiologist and made sure he knew that I normally had low heart rates since I'm an athlete so he wouldn't freak out. (Low 50's is not uncommon and I've even seen it in the upper 40's.) He said as long as it was stable he didn't care what it was. He also knew that athletes don't need as much to put them out because of high metabolism. (Most athletes I know are light-weights with alcohol for that reason.) The surgery itself went fine and they sent me on my way. The fun thing about the blue dye is that it turns your boob bright Smurf blue and you get to pee like a Smurf for several hours.

Recovery from surgery was more difficult than the surgery itself. I'm not good at being laid up. I had a fair amount of swelling that was very uncomfortable, especially around the incisions, which were tight and the swelling made it feel like I had a rope around my armpit. I’d never had surgery before and had no idea what to expect, plus I had fears of long term problems that can happen when you take lymph nodes out. Was told that I should be able to resume normal activities a few days after surgery, but I’m not sure what is normal for me is what they had in mind. I tried skiing 4 and 5 days after surgery and probably did too much, but I was so anxious to get out and do something. I felt fine at the time but had a lot of swelling and discomfort afterwards. I was told that it was probably due to the exercise because it increases circulation and the fluid can’t leave that area as fast as it enters yet. I didn’t know when I’d be able to comfortably ski again and I was distraught at this because it’s really hard to go without my best stress reliever during this stressful time. After seeing the doctor about it he said that the swelling wasn’t a problem in itself and I should do whatever I comfortably can. That reassured me at least and I tried to be patient and waited another week. I went easier this time and seemed to feel ok the next day. So I’m back out, if not working as hard as I’d like to be. The doctor commented that the women like me that complained the most of slow recovery were all athletes and he thought they had higher expectations than most. I’m sure that’s true. I’ll bet there are plenty of people out there that are happy to have an excuse to lie around for a couple weeks and wouldn’t notice or care if they didn’t regain 100% function, but I am not one of them.

I got the lab report back from surgery and there was good news and bad news. The good news was that the nodes were completely clear of cancer so no chemo will be needed and we won’t need to radiate the nodes in my armpit which can cause additional side effects. The bad news was that there is still a little cancer left and I need another surgery to get it out. So I go in on Monday to do it. It’ll be a quicker procedure using the same incision and local anesthesia, but I’ll be starting over with recovering from surgery and swelling and whatnot. Plus that means that I can’t start radiation treatments until January. Not great, but it is what it is and I’m better prepared this time.

All this started just before Thanksgiving and I kept thinking how grateful I was that I had good insurance and could afford the co-pays because there are so many that are not so fortunate. Radiation treatment alone can cost $20,000. A woman I grew up with had breast cancer several years ago and started a non-profit to help women pay for it. Check it out http://www.payitforwardfund.net/.

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